actual contribution means the actual amount a patient pays for each prescription, including a special patient contribution.
Note: Does not include any charge for delivery, or for supply of a pharmaceutical benefit outside normal trading hours.
allowable discount has the meaning given by subsection 87(2AAAA) of the Act.
A section means:
(a) in respect of an authority prescription, a repeat authorisation, a deferred supply authorisation, or a prescriber bag supply form—the section of the form upon which the prescription is written that is provided for the purpose of recording the information required in the provision in these Rules in which the expression occurs; and
(b) in respect of a prescription other than a prescription specified in paragraph (a)—the section of the stamp format marked “A” appearing on the prescription.
approved private hospital means a private hospital that has an approved hospital authority.
approved public hospital means a public hospital that has an approved hospital authority.
approved supplier has the same meaning as in Part VII of the Act.
authority prescription means a prescription that prescribes a pharmaceutical benefit and that has been authorised:
(a) in accordance with subsection 30(4) of the Regulations; or
(b) in accordance with authority required procedures that:
(i) are part of the circumstances determined by the Minister under paragraph 85(7)(b) of the Act for the pharmaceutical benefit; or
(ii) are part of the conditions determined by the Minister under subsection 85A(2A) of the Act for the pharmaceutical benefit; or
(iii) are incorporated by reference into the circumstances determined for the pharmaceutical benefit under subsection 85B(4) of the Act.
Note: A Streamlined Authority Code appearing in the prescription may satisfy subparagraph (b)(i), (ii) or (iii) of the definition of authority prescription.
claim means information given, and procedures followed by, an approved supplier to make a claim for payment under section 99AAA of the Act for the supply of a pharmaceutical benefit.
Claims Transmission System has the same meaning as in subsection 99AAA(1) of the Act. It means the procedures defined in rule 6 of these Rules, to be followed by approved suppliers in providing information by electronic means to the Secretary in relation to the supply by them of pharmaceutical benefits.
continued dispensing means a supply of a pharmaceutical benefit by an approved pharmacist in accordance with subsection 89A(1) of the Act and the Regulations.
contribution discount means the amount of the allowable discount for a supply other than an early supply of a specified pharmaceutical benefit.
Note: The contribution discount may be greater than one dollar in the limited cases where subsection 92A(2) of the Act applies to a supply of a pharmaceutical benefit by a friendly society or a friendly society body to an eligible member.
deferred supply authorisation means a deferred supply authorisation prepared under section 53 of the Regulations upon which a pharmaceutical benefit has been supplied.
early supply of a specified pharmaceutical benefit has the same meaning as in subsection 84AAA(1) of the Act.
electronic communication has the meaning given by subsection 5(1) of the Electronic Transactions Act 1999.
electronic prescription has the same meaning as in the Regulations.
exceptional prescription means a prescription for an extemporaneously‑prepared pharmaceutical benefit that is not a standard formula preparation and for which the price of the ingredients calculated in accordance with sections 19 to 21 of the determination made under paragraph 98B(1)(a) of the Act is not less than twice the amount calculated in accordance with section 30 of that determination, excluding the container price and dispensing fee.
extemporaneously‑prepared pharmaceutical benefit means a pharmaceutical benefit in respect of which there is not in force a determination under subsection 85(6) of the Act.
healthcare identifier has the same meaning as in the Healthcare Identifiers Act 2010.
healthcare provider organisation has the same meaning as in the Healthcare Identifiers Act 2010.
information technology requirements has the meaning given by subsection 5(1) of the Electronic Transactions Act 1999.
manual system has the same meaning as in subsection 99AAA(1) of the Act. It means the procedures defined in rule 8 of these Rules, to be followed by approved suppliers in providing information otherwise than by electronic means to the Secretary in relation to the supply by them of pharmaceutical benefits.
Medicare Australia/DVA copy, for a paper‑based prescription, means the duplicate of the prescription on which appear the words ‘Medicare Australia/DVA copy’.
medication chart prescription has the same meaning as in the Regulations.
paper‑based prescription has the same meaning as it does in the Regulations.
PBS prescriber, in relation to a prescription, means the PBS prescriber (within the meaning of Part VII of the Act) who wrote or prepared the prescription.
pharmaceutical benefit has the same meaning as in Part VII of the Act.
prescriber bag supply form means:
(a) an order form for the purpose of section 33 of the Regulations; or
(b) a form for the purpose of an approved medical practitioner giving notice of obtaining a pharmaceutical benefit when making a claim using the manual system, as mentioned in subsection 36(4) of the Regulations; or
(c) a form for the purpose of an approved medical practitioner creating a written record of obtaining a pharmaceutical benefit if he or she makes a CTS claim in relation to obtaining the benefit, as mentioned in subsection 36(7) of the Regulations.
prescription includes the following:
(a) the Medicare Australia/DVA copy of a paper‑based prescription;
(b) a copy of a medication chart prescription that is not an electronic prescription;
(c) an electronic prescription.
Regulations means the National Health (Pharmaceutical Benefits) Regulations 2017.
RPBS means the:
(a) Repatriation Pharmaceutical Benefits Scheme, a legislative instrument made under section 91 of the Veterans’ Entitlements Act 1986; or
(b) Repatriation Pharmaceutical Benefits Scheme (Australian Participants in British Nuclear Tests) 2006, a legislative instrument made under section 18 of the Australian Participants in British Nuclear Tests (Treatment) Act 2006; or
(c) MRCA Pharmaceutical Benefits Scheme, a legislative instrument made under paragraph 286(1)(c) of the Military Rehabilitation and Compensation Act 2004.
repeat authorisation means:
(a) a repeat authorisation prepared under section 52 of the Regulations using a repeat authorisation form; or
(b) continued dispensing using a repeat authorisation form prepared by an approved pharmacist;
upon which a pharmaceutical benefit has been supplied.
repeat authorisation form has the meaning given in the Regulations.
S section means:
(a) in respect of an authority prescription, a repeat authorisation, a deferred supply authorisation or a prescriber bag supply form, the section of the form upon which the prescription is written that is provided for the purpose of recording the information required in the provision in these Rules in which the expression occurs; and
(b) in respect of a prescription other than a prescription specified in paragraph (a), the section of the stamp format marked “S” appearing on the prescription.
stamp format means the following format, whether made by stamp or otherwise and whether or not the lines are omitted:
S
A
standard formula preparation means an extemporaneously‑prepared pharmaceutical benefit that is listed in Schedule 5 to the determination in force under paragraph 98C(1)(b) of the Act.
under co‑payment data means information relating to a supply of a pharmaceutical benefit by:
(a) an approved supplier where subsection 99(2A), 99(2AB) or 99(2B) of the Act applies; and
(b) an approved hospital authority where the amount payable by the Commonwealth in accordance with a subsection 99(4) determination is nil due to the dispensed price not exceeding the applicable patient co‑payment, as defined in the subsection 99(4) determination.
Note: When subsection 99(2A), 99(2AB) or 99(2B) of the Act applies, no claim is payable under section 99AAA of the Act.
(2) A reference in these Rules to the supply of a pharmaceutical benefit includes a reference to the obtaining of a pharmaceutical benefit by an approved medical practitioner for the purpose of the supply of the benefit under section 93 of the Act.